North American Registry of Midwives (NARM) Practice Exam

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What is the primary characteristic of a breech presentation in terms of palpation?

  1. The head is articulated with the cervix

  2. The breech is located in the fundus

  3. The small parts are clear and easily outlined

  4. The cephalic prominence is marked and clear

The correct answer is: The breech is located in the fundus

In a breech presentation, the primary characteristic noted during palpation is that the breech, or the fetal buttocks, is typically located in the fundus of the uterus. This positioning is significant because it indicates that the pelvis is not engaged with the cervix, which is essential for determining the type of delivery approach needed. When palpating a pregnant abdomen, if the buttocks are felt in the fundal area, this strongly suggests a breech presentation. Other characteristics, such as the articulated head with the cervix or the marked cephalic prominence, do not align with the nature of a breech position, as the head is not typically in the engaged position you would expect in a vertex presentation. Therefore, identifying the position of the breech in the fundus is critical for midwives and healthcare providers in assessing the baby's presentation and planning accordingly for labor and delivery.

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